12/19/2025
Texas Medicaid providers may receive medical records request from Blue Cross and Blue Shield of Texas from February through June 2026. We collect data for Healthcare Effectiveness Data and Information Set (HEDIS®) measures. on the quality of our members’ care and their health outcomes.
How you can help: BCBSTX may contact you by fax or phone to provide details about the records needed and how you can return them to us. Please promptly provide complete and accurate records.
Patient authorization isn’t required to release these records, as their collection and review is considered a component of health care operations under the Health Insurance Portability and Accountability Act of 1996.
The data we’re seeking: We collect data related to chronic conditions such as diabetes and high blood pressure, and transitional care.
Please contact your Texas Medicaid Quality Improvement Department via email TX_Medicaid_QI@bcbstx.com.
Other records requests throughout the year may include requests related to risk adjustment, focusing on chart reviews and the accuracy of risk-adjustable codes submitted to the Centers for Medicare & Medicaid Services.
Resources
For Texas Medicaid Provider Quality Improvement, review the following resources ranging from quality measures data to current vaccine schedules:
• Clinical Practice Guidelines
• ImmTrac2 Texas Immunization Registry
• Quality Improvement Toolkit and Tip Sheets for Medicaid providers
• Texas Health Steps for Medical Providers